Purpose: Syphilis, caused by , presents a diagnostic challenge due to its diverse clinical manifestations. Neurosyphilis has seen a resurgence in recent years, particularly among men who have sex with men and those living with HIV. Diagnosis of neurosyphilis in emergency settings is challenging due to its varied neurological presentations. This study aims to serve as a reference for dermatologists and neurologists in diagnosing and treating neurosyphilis.
Patients And Methods: This retrospective study analyzed patients who presented with neuropsychiatric symptoms and were ultimately diagnosed with neurosyphilis. These patients were collected from the emergency department in Peking Union Medical College Hospital between January 2018 and November 2023. The medical history, clinical symptoms, laboratory examinations, cranial MRI characteristics, and treatment regimens of these patients were investigated.
Results: Among the included 12 neurosyphilis patients, memory deterioration was observed in 8 out of the 12 neurosyphilis patients. Diagnosis often resulted in delays, with misdiagnoses mainly including Alzheimer's disease, stroke, and epilepsy. Neuroimaging revealed various abnormalities, predominantly affecting ventricular and temporal regions. Treatment with penicillin-based regimens varied in compliance, with only a minority of patients adhering to guidelines. Treatment outcomes were inconsistent, with some patients experiencing irreversible neurological damage and fluctuating serum rapid plasma reagin (RPR) titers.
Conclusion: Diagnosis of neurosyphilis in the emergency department remains challenging, necessitating awareness of its varied neurological presentations. Enhanced diagnostic strategies are imperative to accelerate treatment initiation and improve outcomes for affected individuals.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531749 | PMC |
http://dx.doi.org/10.2147/IDR.S482264 | DOI Listing |
Int J STD AIDS
December 2024
Genitourinary Clinic, Department of Dermatology and Venereology, Mater Dei Hospital, Msida, Malta.
The resurgence of syphilis across Europe has led to a growing number of atypical cases, often characterised by varied symptoms that can delay diagnosis. We report the case of a young man who has sex with men (MSM), presenting with persistent headaches and swelling of the forehead suggestive of giant cell arteritis (GCA). Despite a recent negative syphilis test, further investigations confirmed the diagnosis of neurosyphilis.
View Article and Find Full Text PDFCureus
October 2024
Infectious Disease, Maimonides Medical Center, Brooklyn, USA.
Cureus
October 2024
Emergency Medicine, Columbia University College of Physicians and Surgeons, New York, USA.
Papilledema is a high-risk cause of vision changes in the Emergency Department (ED) and a critical physical examination finding because of its close association with etiologies that may progress to vision loss or death. Syphilis is a rare infectious cause of papilledema, with scarce case reports published showing its ability to develop such sequela. We present a case of a 35-year-old male with a past medical history of newly diagnosed HIV who originally presented to the ED with a rash and rapidly worsening visional changes.
View Article and Find Full Text PDFInfect Drug Resist
October 2024
Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, People's Republic of China.
Purpose: Syphilis, caused by , presents a diagnostic challenge due to its diverse clinical manifestations. Neurosyphilis has seen a resurgence in recent years, particularly among men who have sex with men and those living with HIV. Diagnosis of neurosyphilis in emergency settings is challenging due to its varied neurological presentations.
View Article and Find Full Text PDFActas Dermosifiliogr
October 2024
Servicio de Dermatología, Fundación Jiménez Díaz, Madrid, España; Grupo investigación en ITS y VIH de la AEDV.
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